Surgical clip device

ABSTRACT

In order to provide a surgical clip device with which the closure of vessels is successfully achieved even more safely, particularly in neurosurgery, it is proposed that the surgical clip device be provided with at least two electrically conductive clip parts that are electrically isolated from each other (by an element) and are arranged at a predetermined distance opposite each other.

This application is a continuation of international application numberPCT/EP2011/066125 filed on Sep. 16, 2011 and claims the benefit ofGerman application number 10 2010 037 748.1 filed on Sep. 23, 2010,which are incorporated herein by reference in their entirety and for allpurposes.

BACKGROUND OF THE INVENTION

The invention relates to a surgical clip device, in particular forclosing vessels in neurosurgery.

To this end, metallic clips formed in a U-shape or V-shape are widelyused, these clips being placed on the vessel with a clip applyingforceps and, when deformed through the closing force of the forceps,effecting closure of the vessel concerned. Such clips are known forexample from DE 195 20 158 C2.

In order to make more secure the closure of a vessel by a clip,so-called double-web clips have already been proposed (cf. for exampleDE 10 2006 001 344 A1) in which two U-shaped or V-shaped clamps of theclip that are formed integrally with each other and are arrangedsubstantially parallel to each other form two points of closure at thevessel which are located one behind the other in a longitudinaldirection of the vessel.

It can nevertheless still happen in critical situations that even such adouble closure of the vessel does not prevent small leakages, thus stillallowing small amounts of blood to leak therefrom.

It is an object of the invention to propose a surgical clip device withwhich the closure of vessels is successfully achieved even more safely,particularly in neurosurgery.

SUMMARY OF THE INVENTION

This object is attained by a surgical clip device as defined in claim 1.

Accordingly, the surgical clip device constructed in accordance with theinvention relies not only on a mechanical closure of the vessel in whichthe two clip parts in the form of clamp arms, typically constructed ofmetal, hold the vessel in compression over its cross-section and thusclose it shut, but owing to the clip parts or clamp arms beingconfigured so as to be electrically isolated from each other, it ispossible, concurrently with the application of the surgical clip device,to initiate a coagulation or sealing process in the area of the clip sothat besides the mechanical closure a substance to substance-bondedclosure of the vessel is additionally achieved.

An additional advantage is evident in that the coagulation and sealingprocess causes stiffening of the tissue in the coagulation region and asa result of this the clip device is additionally given more firmsupport. For that purpose, a clip applicator constructed in accordancewith the invention is preferably used which will be described in moredetail below.

The surgical clip device with its two electrically conductive clipparts, in particular clamp arms, arranged in electrical isolation fromeach other, can be implemented in a wide variety of embodiments.

In particular, the clip parts are part of a U-shaped or V-shaped clipconfiguration, wherein the two clip parts are held at a first endthereof on an electrically isolating holding part, thereby forming thetwo legs of the U-shaped or V-shaped configuration.

Preferably, the electrically isolating holding part is plasticallydeformable.

Typical materials used for the isolating holding parts are plasticsmaterials.

Provision is in particular made for the two clip parts to be configuredsymmetrically with respect to one another, with the electricallyisolating holding part being kept as small as possible in order toprovide as large a sphere of action as possible for the coagulationprocess occurring through the electrically conductive clip parts.

In particular, the two clip parts are of substantially identicalconfiguration and are arranged in a mirror image relationship with theirfirst end fixed to the electrically isolating holding part.

Alternatively, the electrically isolating holding part can be locatedasymmetrically on the U-shaped or V-shaped clip so that a first clippart or clamp arm comprises the one leg and the central arcuate part,while the electrically isolating holding part and the second clip partor clamp arm form the other leg. Here, the plastic deformation does notinevitably occur on the holding part but takes place primarily on thecentral arcuate part of the one clip part, which typically consists of ametal material.

In a more preferred embodiment of the surgical clip device constructedin accordance with the invention, provision is made for the clip partsor clamp arms to be capable of being connected together at theirrespective free end opposite the first end thereof by way of anelectrically isolating connection.

The connection is preferably configured as a latched connection.

To this end, it is in particular provided for electrically isolatinglatch elements to be arranged at the free ends of the clip parts, saidlatch elements latching into engagement with each other upon mechanicalclosure of the clip, thus already providing additional mechanical fixingof the clip at the vessel that is to be closed off.

As an alternative to the latched connection, provision may also be madefor the electrically isolating connection to be a substance tosubstance-bonded connection forming at the free ends of the clip partsas a result of heat generated during the coagulation and sealingprocess.

In another embodiment of the surgical clip devices constructed inaccordance with the invention, provision may be made for two clip parts,each of substantially U-shaped or V-shaped configuration, to be held inparallel alignment with each other and spaced apart at a predetermineddistance. For application to a vessel, said two clip parts are graspedby a clip applicator, said clip applicator comprising a gripping toolfor the two clip parts having gripping jaws which are electricallyisolated from each other. The two clip parts can then be applied to thevessel using the clip applicator, and in the same step a sealing actionin the area of the mechanical closure of the vessel can be achieved by acoagulation current. Here, the coagulation procedure results in anadditional closure of the vessel that is substance to substance-bonded.

The two clip parts may lack any connection to each other and just beheld ready in a desired array, for example in a magazine, until receivedby the gripping tool. After withdrawal from the magazine and untilapplication, the two clip parts are held in an electrically isolated andspaced-apart relationship to each other by the mutually electricallyisolated gripping jaws.

More preferably, the two clip parts are releasably held in parallelalignment with each other and spaced apart at the predetermined distancein a holding device. In such clip devices constructed in accordance withthe invention, the configuration of the gripping jaws of the clipapplicator allows for a somewhat simpler design.

Alternatively, provision may be made for the two clip parts to befixedly connected in parallel alignment with each other and spaced apartat the predetermined distance by an electrically isolating holder. Theholder in turn can be made of a plastics material. In that case as well,the configuration of the gripping jaws of the clip applicator issimplified.

The holder can be of one-piece configuration and for exampleinterconnect the two clip parts at the respective mid-regions thereof.

In a more preferred embodiment, the free ends of the two clip parts arein each case connected together by way of an electrically isolatingholding part of the holder.

More preferably, said two holding parts of the holder can then also beconfigured in the form of latch elements which latch into engagementwith each other when the clip is applied to the vessel.

As has already been described above, it may also be provided that, inlieu of the latch elements, electrically isolating holding parts be usedthat together form a substance-to-substance bond by heat generatedduring the coagulation and the sealing of the vessel.

Also in this case, the free clip ends are fixedly connected to eachother, and thus the vessel, besides being mechanically secured by thedouble clip device as described above, is additionally sealed via thecoagulation procedure.

The invention further relates to a clip applicator for use with asurgical clip device constructed in accordance with the invention, asdescribed above.

The applicator constructed in accordance with the invention comprises agripping tool having two mutually electrically isolated gripping jawsfor the two clip parts, wherein the gripping jaws are capable of beingconnected to a coagulation current-delivering current source.

More preferably, the applicator comprises a magazine having a clipcarrier, wherein the clip carrier has a plurality of surgical clipdevices arranged thereon as described above.

The current source with which the gripping jaws of the applicator can beconnected is preferably a high-frequency current source.

These and further advantages of the invention are described in moredetail below with reference to the drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIGS. 1A, 1B show two variants of a first embodiment of a surgical clipdevice constructed in accordance with the invention;

FIGS. 2A, 2B show two variants of a second embodiment of a surgical clipdevice constructed in accordance with the invention;

FIG. 3 illustrates a clip applicator constructed in accordance with thepresent invention; and

FIGS. 4A to 4D show schematically a sequence of steps in the process ofapplying a clip device constructed in accordance with FIG. 2A or 2B.

DETAILED DESCRIPTION OF THE INVENTION

FIG. 1A shows a surgical clip device 10 (hereinafter also referred to asclip) having two electrically conductive clip parts or clamp arms in theform of legs 12 and 14 which are held in a substantially U-shapedarrangement in electrical isolation from each other by a holding part 16and are held spaced apart at a predetermined distance from each otherand in opposed relationship with respect to each other. When the clip 10is applied to a vessel, the two legs 12 and 14 are urged toward eachother from two sides of the vessel and are maintained electricallyisolated from each other by way of the holding part 16. The holding partis fabricated from a plastically deformable plastics material so thatapplying the clip 10 results in a permanent mechanical closure of thevessel. In the compressed state, a coagulation current is then appliedvia a gripping tool of an applicator so that the vessel, apart frombeing mechanically closed shut, is additionally sealed off.

The clip device 20 depicted in FIG. 1B has asymmetrically configuredclamp arms in the form of legs 22, 24 and an electrically isolatingholding part 26 correspondingly arranged in an off-centre position.

When the clip 20 is applied, plastic deformation takes place primarilyon an arcuate part 28 integrally formed on the leg 22, thereby providingfor a permanent mechanical closure of the vessel.

FIG. 2A shows a surgical clip device 30 in which two clip parts or clamparms 32, 34, each of substantially U-shaped configuration, are arrangedparallel to each other. These two clip parts can, for example at amid-region thereof, be joined together, and held in a spaced-apartrelationship, by a web 36 made of an electrically isolating material,such as a plastics material.

A more preferred clip device, however, is a clip device 40 illustratedin FIG. 2B in which two U-shaped clip parts or clamp arms 42, 44 are, attheir respective free ends 52,53; 54,55, held in electrically isolatedand spaced-apart relationship via two holding parts 46, 48, with theholding part 46 being preferably provided with a latch element 50 thatis of hook-shaped configuration in FIG. 2B and is connectable to theholding part 48 in a form-locked manner.

Alternatively or additionally, provision may be made for the material ofthe holding parts 46, 48 or in particular also of the latch part 50 tobe selected such that the heat generated from coagulation of the vesselmaterial is sufficient to effect a substance-to-substance bond betweenthe holding parts 46, 48, in particular between the part designated 50and the part designated 48.

FIG. 3 illustrates a clip applicator 70 constructed in accordance withthe invention, wherein the portion of the handle for operating theapplicator 70 is omitted for simplicity.

Shown in FIG. 3 is a shaft 72 of the applicator 70, said shaft 72 havingarranged therein a clip magazine 74 with clips 40 situated in a row onebehind the other. The shaft 72 has on its distal end a gripping tool 71comprising two gripping jaws 76, 77 and 78, 79 held in electricallyisolated relationship from each other and which, when a clip 40 isapplied, receive and guide, in receiving grooves 80, 81; 82, 83 thereof,the clip parts 42, 44 of the clip 40 with the free ends 52, 53; 54, 55thereof.

Once a clip 40 has been positioned at a vessel using the gripping tool71, the gripping jaws 76, 77; 78, 79 can be pivoted relative to oneanother by a handle (not shown) of the applicator 70 so that the clip 40is squeezed together, which first results in a double mechanical closureof the vessel; this will be explained in greater detail in conjunctionwith the schematic drawings of FIGS. 4A to 4D.

Because the gripping jaws 76, 77; 78, 79 of the clip applicator 70 areheld in electrically isolated relationship, a current may then beapplied to them, and the physical contact established between the freeends of the legs 52, 53; 54, 55 of the clip 40 and the gripping jaws 76,77; 78, 79 also establishes an electrically conductive contacttherebetween so that the electric current can be delivered to the legsof the clip 40.

The sequence of steps for applying a clip device constructed inaccordance with the invention is schematically shown in FIGS. 4A to 4D,taking as an example the clip device 40 constructed in accordance withthe invention as illustrated in FIG. 2B. The procedure appliesanalogously to the clips of FIGS. 1A, 1B and 2A.

FIG. 4A is a sectional view of the clip 40 with its legs 52, 54 locatedbelow a vessel 100 and legs 53, 55 located above the vessel 100. Thelegs 52, 54 are guided and held in grooves 82, 83 of the gripping jaws78, 79, and the legs 53, 55 are guided and held in grooves 80, 81 of thegripping jaws 76, 77.

In the next step, as shown in FIG. 4B, the gripping jaws 76, 77 and 78,79 are moved toward each other, thereby approximating the legs 52, 54and 53, 55 toward each other, thereby mechanically closing the vessel100 in the regions 102 and 104 thereof, said regions 102 and 104 beingspaced apart in a longitudinal direction of the vessel.

In the closed position of the clip 40, the part designated 50 thenlatches into engagement with the holding part 48, thus securing theclosed position of the clip 40.

Subsequently, the gripping jaws 76, 78 and 77, 79 are connected in pairsto a terminal of a HF current source so that a coagulated region 106 ofthe vessel 100 then forms between the mechanically closed-off regions102, 104 of the vessel 100 (cf. FIG. 4C).

As soon as the coagulation procedure is complete, which typically onlytakes few seconds/the fraction of a second, the gripping jaws 76, 77;78, 79 are returned to their initial position and the applicator 70 isremoved from the vessel 100. This leaves the vessel 100 with the legs52, 53 and 54, 55 of the clip 40 applied to the vessel 100 andmechanically interlocked via the holding parts 46, 48, 50, wherein inaddition to the double mechanical closure of the vessel 100 in theregions 102, 104, additional safety is provided by a coagulated region106 (FIG. 4D).

The invention claimed is:
 1. Surgical clip device for closing vessels,comprising: two electrically conductive clip parts arranged inelectrical isolation from each other and spaced apart at a predetermineddistance opposite each other; each of the two clip parts having asubstantially U-shaped or V-shaped configuration and being held inparallel alignment with each other at the predetermined distance, andeach of the two clip parts having two respective free ends, wherein: thetwo respective free ends of each clip part are adapted to be movedtowards one another during an application procedure to form two clampingregions in a vessel to be closed, the two clamping regions being spacedapart at the predetermined distance, and in a closed position of theclip, each of the free ends of the two clip parts are configured toapply a coagulation current to the vessel so as to form a coagulatedregion of the vessel extending continuously between the two spaced apartclamping regions.
 2. Surgical clip device in accordance with claim 1,wherein each of the two clip parts are held with a first free end of thetwo free ends thereof on an electrically isolating holding part. 3.Surgical clip device in accordance with claim 2, wherein the two clipparts have a substantially mirror image configuration relative to oneanother and are each symmetrically held with the first free end thereofon the electrically isolating holding part.
 4. Surgical clip device inaccordance with claim 2, wherein the two free ends of the respectiveclip parts opposite the first free ends thereof are connectable to eachother by way of an electrically isolating latched connection. 5.Surgical clip device in accordance with claim 1, wherein the two clipparts are releasably held in parallel alignment with each other andspaced apart at the predetermined distance in a holding device. 6.Surgical clip device in accordance with claim 1, wherein the two clipparts are fixedly connected in parallel alignment with each other andspaced apart at the predetermined distance by an electrically isolatingholder.
 7. Surgical clip device in accordance with claim 6, wherein theholder comprises a first holding part which fixedly connects the twoclip parts.
 8. Surgical clip device in accordance with claim 7, whereinthe holder further comprises a second holding part, wherein the firstholding part connects first ones of each of the two free ends of therespective clip parts which are adjacent one another and the secondholding part fixedly connects second ones of the two free ends of therespective clip parts which are adjacent one another.
 9. Surgical clipdevice in accordance with claim 8, wherein the first and second holdingparts are connectable to each other.
 10. Surgical clip device inaccordance with claim 9, wherein the first and second holding parts arereleasably connectable to each other.
 11. Surgical clip device inaccordance with claim 9, wherein the first and second holding parts arelatchingly connectable to each other.
 12. Clip applicator for use with asurgical clip device, the surgical clip device comprising: twoelectrically conductive clip parts arranged in electrical isolation fromeach other and spaced apart at a predetermined distance opposite eachother, each of the two clip parts having a substantially U-shaped orV-shaped configuration and being held in parallel alignment with eachother at the predetermined distance, and each of the two clip partshaving two respective free ends, wherein the two respective free ends ofeach clip part are adapted to be moved towards one another during anapplication procedure to form two clamping regions in a vessel to beclosed, the two clamping regions being spaced apart at the predetermineddistance, and the applicator comprising a gripping tool having mutuallyelectrically isolated gripping jaws for the two clip parts, wherein: thegripping jaws are connectable to a coagulation current-deliveringcurrent source, and in a closed position of the clip, the coagulationcurrent-delivering current source applies a coagulation current to eachof the free ends of the two clip parts such that each of the free endsof the two clip parts apply the coagulation current to the vessel,forming a coagulated region of the vessel extending continuously betweenthe two spaced apart clamping regions.
 13. Clip applicator in accordancewith claim 12, wherein the applicator comprises a magazine having a clipcarrier, wherein the clip carrier has arranged thereon a plurality ofsurgical clip devices.
 14. Clip applicator in accordance with claim 12,wherein the current source is a high-frequency current source.